VITROS CHEMISTRY PRODUCTS LI SLIDES 1632660

MAUDE Adverse Event Report

MAUDE data represents reports of adverse events involving medical devices. This maude entry was filed with the FDA on 2018-04-18 for VITROS CHEMISTRY PRODUCTS LI SLIDES 1632660 manufactured by Ortho-clinical Diagnostics.

Event Text Entries

[106604589] The investigation determined the higher than expected vitros li results were obtained for multiple samples from a single patient processed on a vitros 5600 integrated system. The assignable cause of the event was user error associated with processing lithium testing on the vitros analyzer using a sample tube type (lithium heparin) that is not recommended for use with the vitros lithium assay per the vitros lithium instructions for use.
Patient Sequence No: 1, Text Type: N, H10


[106604590] The customer obtained higher than expected vitros lithium (li) results for multiple samples drawn from a single patient processed using a vitros 5600 integrated system. Patient sample results of 1. 4 and 1. 7 mmol/l vs. The expected result of 0. 3 mmol/l biased results of the direction and magnitude observed may lead to inappropriate physician action. The lithium results were reported out of the laboratory and questioned by an emergency room medical professional. It was confirmed that no treatment was altered, initiated or stopped based upon the reported results. It was expected that a corrected report with only the serum lithium result would be sent out. There was no allegation of patient harm as a result of this event. This report is number 2 of 2 mdr? S for this event. Two (2) 3500a forms are being submitted for this event as 2 devices were involved. (b)(4).
Patient Sequence No: 1, Text Type: D, B5


MAUDE Entry Details

Report Number1319809-2018-00068
MDR Report Key7441333
Date Received2018-04-18
Date of Report2018-04-18
Date of Event2018-03-19
Date Mfgr Received2018-03-21
Device Manufacturer Date2017-11-12
Date Added to Maude2018-04-18
Event Key0
Report Source CodeManufacturer report
Manufacturer LinkY
Number of Patients in Event0
Adverse Event Flag3
Product Problem Flag3
Reprocessed and Reused Flag3
Health Professional3
Initial Report to FDA3
Report to FDA3
Event Location3
Manufacturer ContactMR. JAMES A STEVENS
Manufacturer Street100 INDIGO CREEK DRIVE
Manufacturer CityROCHESTER NY 14626
Manufacturer CountryUS
Manufacturer Postal14626
Manufacturer Phone5854533000
Manufacturer G1ORTHO-CLINICAL DIAGNOSTICS
Manufacturer Street513 TECHNOLOGY BLVD.
Manufacturer CityROCHESTER NY 14652
Manufacturer CountryUS
Manufacturer Postal Code14652
Single Use3
Previous Use Code3
Event Type3
Type of Report0

Device Details

Brand NameVITROS CHEMISTRY PRODUCTS LI SLIDES
Generic NameIN-VITRO DIAGNOSTIC
Product CodeJIH
Date Received2018-04-18
Catalog Number1632660
Lot Number3126-0111-5481
ID Number10758750009466
Device Expiration Date2019-05-01
OperatorHEALTH PROFESSIONAL
Device AvailabilityY
Device Eval'ed by MfgrY
Device Sequence No1
Device Event Key0
ManufacturerORTHO-CLINICAL DIAGNOSTICS
Manufacturer Address100 INDIGO CREEK DRIVE ROCHESTER NY 14626 US 14626


Patients

Patient NumberTreatmentOutcomeDate
10 2018-04-18

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